What's in a Name

I am beginning to make plans to take Elvis to another farm for the next stage of his rehab. Dr. Arensberg said that we have probably achieved all the benefits of the cold sea water spa and it's time to start slowly increasing Elvis' hand-walking. It's going to be hard to leave the Jacksons and their staff at the Fair Hill Equine Therapy Center. All of them have taken such good care of Elvis (and me) through these critical first couple of months. We'll probably go through some sort of withdrawal...

His hock still looks big, which you can see in the picture. But imagine, if you will, swelling that went from the point of his hock all the way down to his fetlock. That's what it looked like the day I took him up to Fair Hill. If you look closely, you can see a bulge right where the clipped hair changes over to unclipped. That's the superficial digital flexor tendon as it wraps back to it's proper place from the side of his hock. But, his hoof is finally hitting flush with the ground most of the time. And he enjoys hanging out with his buds in the spa. It's kind of hard to see but the water comes up almost to his chest and it bubbles just like a jacuzzi. The cold and the massaging action of the bubbles really helps keep the swelling down. They are walking him more now too and they tell me he enjoys strolling around the barn with the racehorses. He looks pretty out of place in that lineup. Sort of like a moose compared to all of the lean racing-fit TBs that are in the barn...

Elvis demonstrated to his grooms how he came to get his barn name. When I bought him 5 years ago, his barn name was Junior. I didn't really get why they called him that. It wasn't because he looked like his sire and it was a bit too convoluted for me to want to keep it. I just figured that I would change it when something came to mind.

When I first started working with him, I would longe him before I would get on because he could be pretty electric. One of the first times I did this, we were finishing up and I asked him to halt and began to roll up the longe line as I walked closer to him. He struck the most amazing pose, arching his neck, slowly shaking his head, and as I got closer, he gave out this gentle nicker, exactly in the rhythm of "thank you, thank you very much". "Listen to you" I said. "You sound just like Elvis!" as I patted his neck. "But don't worry, I won't call you that" I confidently told him. "I'm not such a big fan."

The whole thing tickled me though, and I told several of my friends about it. They kept calling him Elvis even though I really didn't want that name to stick, but you know how that works. And now, I love to hear that nicker (his Elvis impersonation as I've come to call it) and the grooms at FHETC think it's pretty funny. Because most of them are Latino, they call him "Elveese", which I think is pretty cool.

I Think I'm Going To Like It Here

Elvis has been at the Fair Hill Equine Therapy Center for almost 2 months now. I go up every weekend to visit and to monitor his progress. Every week brings encouragement. His leg is looking much better and he is putting much more weight on his hoof. That cold sea water spa is almost a miracle cure. Amy Jackson, Bruce's wife, has been great. She got him this cool hay net that has very tiny openings so he has to work at getting his hay. Keeps his busy mind occupied.

In fact, Elvis has surprised me in how well he has settled in. I have taken to calling his stall "the corner office". The barns at the facility are set up so that the stalls are back to back and the dirt aisle goes around the entire barn. They make great use of this when the weather is bad so they can continue to work or hand walk the horses, as needed. Elvis' stall is at one of the corners closest to the spa. He can look out the front of his stall and he can also look out the side window, as you can see by the photos.There are big windows directly across from the front of his stall so he can see what's going on outside. Perfect location for a busybody type like Elvis. Oh, I forgot to mention that he's directly across from the feed room, so he's the first one fed. I'm beginning to wonder if he thinks this situation is as it should be. He gets fed twice a day, taken to the spa once a day, given all the hay he can eat to keep him occupied, groomed and bathed on a daily basis, and most importantly, no work. And the other day, a cute little blond-haired girl (the daughter of one of the employees) gave him a big piece of carrot. Sort of begs the question "what's wrong with this picture?"....

Last week, I was able to negotiate a bit more walking for Elvis since his leg is looking so much better. He will put that hoof almost all of the way down while he's standing. It's just lacking about 1/4 inch to be flush with the ground. When he walks he no longer hits only on his toe but has just the slightest toe-first landing. I thought his hind leg might swing wide when he walks since the tendon now sits on the side of his hock but was very pleased to see that the stride looks fairly normal. So, Dr. Arensberg, with Equine Veterinary Care, agreed that Elvis can be hand-walked under sedation the long way around the barn instead of going directly across the aisle to the spa. The idea is to try and stretch out that tendon and maybe get that last little bit so his hoof will hit flat to the ground.

I'm liking this "one day at a time" philosophy. Makes every little improvement special.

Say It Isn't So

As I watch Elvis slowly limp into the barn at the therapy center, my heart just sinks. His hind leg is enormous, like a tree trunk, the swelling is so bad. He won't put any weight on that left hind foot and is in fact only walking on the toe. Like some poor imitation of a ballerina.

Dr. A. and his assistant get the digital xray equipment set up and quickly start taking images. While all of this is going on, I can hardly think. I hope it's not broken but what if it is, then what? As the images of his hock start to accumulate, I'm able to breathe a bit easier because they look pretty good. "No breaks" Dr. A pronounces. In fact, he has pretty nice hocks for a 15 year old, I'm told. So we got that going for us...

Now for further examination. Within what seems like less than 30 seconds, Dr. A says, "Betsy, I have your diagnosis." That quickly? Really? Is that good or bad? He has me place my hand so that it is cupping Elvis' hock while he has his foot down. He slowly raises the leg and suddenly I feel a heavy thump on my hand. "OK, that's not normal", I say.

No, that would be his superficial digital flexor tendon that should be staying on the point of the hock as it's flexed. The ligaments that should be holding it in place have been so torn from the fall that they no longer serve their purpose. The official diagnosis is lateral luxation of the superficial digital flexor tendon of the left hind leg. I stand up and ask "what's next, what's the treatment?"

The answers Dr. A gave me were mind-numbing. Surgery is not very successful since there is really nothing that can be stitched to. We could try keeping it bandaged hoping to keep in place and let scarring sort of lock it in position but that hasn't been very successful either. There's no way to know if the tendon has slipped out of place unless I'm willing to wrap and re-wrap many times a day.

Elvis is looking at 2 months of total stall rest, then gradually increasing walking starting with 5 minutes/day. No turnout for at least 2 more months after that and then in a very small paddock until we're confident the scarring is complete but the tendon will always stay on the outside of his hock instead of on top of it. OK, I think to myself. I'm not happy, especially since we just got back into work after his suspensory injury on his front leg, but we can do this. We have to do this.

And then came the really bad news. His career as a dressage horse is going to be very limited at best, Dr. A tells me. Collected work will be out of the question because of the biomechanics of his hind leg and he probably will have a mechanical lameness that will make his gaits irregular. Just what you want in a dressage horse...

Dr. A told me I could take him back home if I wanted but there was no way that I was going to put that poor horse on the trailer again. He was in so much pain and I had no idea where I would take him for his lay-up. Bruce Jackson came in at that point and quickly came up with a plan.

Elvis can stay at the facility. We'll put him in the cold sea water spa twice a day for at least a week and then once a day for the rest of the month and re-assess from there. He can go in a stall that is very close to the spa so he won't have to walk very far. Dr. A gave him Equioxx for several days to help with the pain and the swelling and will follow up with ultrasound examination the next day to check for any further damage.

Great idea! Having used the spa last year for Elvis' suspensory injury, I knew how effective it was. And, as important, I knew that he would be in the best hands until I could find a place closer to home for his long-term rehab.

I went back up the next day before the second round of snow started so I could watch the ultrasound examination. Nothing further was found, which I guess was a good thing. I was still reeling from what his long term outlook was that anything else would have seems almost inconsequential at the time.

What I wasn't prepared for was how good his leg looked. He had been in the spa the day before, right after Bruce came up with his plan and they put him in the spa first thing in the morning before the ultrasound exam. The swelling was down dramatically! Elvis still wasn't putting much weight on that foot but he looked more comfortable which was a huge relief.

As my mind was quickly spinning through all of the possible future problems, thinking of everything that could possibly go wrong, Bruce just calmly told me, "Betsy, let's just take this one day at a time." Great advice.

Heartbreak Hotel

It started with a phone call from the barn manager. My horse, Elvis, had hurt himself badly and I needed to get to the barn quickly. And so began one of the most emotionally draining days I've had since owning this horse.

But before I go into the details of this experience, I need to give a brief back story as to how Elvis came into my life. I have had him for 5 years and it has been quite the journey. He is a beautiful 16.2H bay Hanoverian and was basically green-broke as a 9 year old when I first saw him. When I bought him several months later, I knew it would be a project. It certainly was, but not the type I thought. He had so much apprehension about life in general that the first year was spent teaching him that the world really was pretty safe.

Later posts will go into more detail about what we did to learn to trust each other. Suffice it to say, he has led me down paths I would have never explored if he hadn't been so different from every other horse I had owned.

But I digress. Back to Monday February 8, 2010. I live near Annapolis, Maryland and we had just dug out from 27 inches of snow that had fallen over the weekend. My husband Rick and I were able to get out and make it to the barn after getting "the call". We arrived to find the barn manager holding Elvis in the indoor arena.

They had been taking turns with the horses and letting them out in the indoor arena so they could get out of their stalls. Apparently, snow had come off the roof when it was Elvis' turn. He spooked and ran and slipped in the corner. His hind end came out from under him and when he got up, he was clearly hurt but kept running. And running. And running. They finally caught him right before we got there.

Elvis was dripping wet and holding his left hind leg up and already there was swelling. The manager had given him banamine and azium and we managed to limp him back to his stall. I called my vet, Dr. G, who lives 5 minutes from the barn. She couldn't get to us because the plows hadn't made it back to her neighborhood so she was stranded.

Calls to other vets either went unanswered or they were snowbound, too. Dr. G recommended that we take him somewhere where he could get a full examination and to do it soon. Another big snowstorm was predicted to start the next day and she didn't want us to get trapped again.

We took him to the Fair Hill Equine Therapy Center in Fair Hill, MD. We had been there last year for a suspensory rehab (again, this will be another post) and I trusted the vet, Dr. A, and the owner of the facility, Bruce Jackson.

While my husband went home to get the trailer, I stood by Elvis' stall to keep an eye on him. He was quietly eating his hay and we had put an ice pack on his leg to help keep the swelling down. He would put a bit of weight on his leg which was reassuring.

All of a sudden, he gave out a snort, spun around, and proceeded to stand in the middle of his stall and kick and spin and kick and spin and kick and spin and kick and spin. Double-barreled kicks and connecting with each wall of his stall. As quickly as he started, he stopped but he was clearly agitated. The barn manager came back in and gave Elvis some dormosedan to keep him quiet.

Rick arrived with the trailer and pulled it up close to the barn entrance so Elvis wouldn't have to walk very far. They walked gingerly down the aisle as I scurried around getting things together for the road trip.

I heard Rick talking to Elvis and then I heard the loud clatter of hooves on pavement and Rick shouting "F**K!, F**K!, F**K!" I ran outside to see that Elvis had broken away from Rick, plowed through a large snow bank, and was now chest deep in snow but still trying to run away. It was absolutely horrible, terrifying in fact, watching him struggle in all of that snow.

We were finally able to catch him after about 5 long minutes, give him some more tranq, and get him on the trailer. The ride up to Fair Hill took longer than normal because of ongoing snow removal on I-95 but Elvis handled the ride pretty well. Dr. A and his assistant met us at the door and helped get Elvis off the trailer.

In subsequent (much shorter) posts, I will tell you about the diagnosis, the plan for recovery, and how things are coming along. It is my hope that you will find this interesting and that you will learn about different treatment modalities for his types of injuries. There will also be posts about other training techniques and philosophies that I explored. Please give me feedback and if you've had similar experiences and can offer suggestions. I would love to hear them!